Bhutan, the secluded Buddhist kingdom high in the Himalayas, is known for its unique measure of progress, the Gross National Happiness Index, which includes such factors as community engagement, emotional balance, living standards and health. Another interesting fact about Bhutan, aligned with its commitment to ecological diversity and resilience, is that it is not only carbon neutral, but a carbon sink, due to land protection and reforestation efforts.

However, one fact you might not know about Bhutan is that 5% of all deaths in Bhutan are due to illnesses attributable to household air pollution. Many households in Bhutan still cook and heat their homes using open fires and simple wood stoves. Such inefficient cooking and heating practices produce high levels of household (indoor) air pollution that includes a range of health damaging pollutants such as fine particles and carbon monoxide. According to the World Health Organization (WHO), household air pollution is the single most important environmental health risk worldwide, and women and children are at particularly high risk from exposure. In poorly ventilated dwellings, smoke in and around the home can exceed acceptable levels for fine particles 100-fold, a significant risk factor for a range of health issues including stroke, lung cancer, and childhood pneumonia.

This link between household air pollution and health is where UCSF comes into the picture.

Workshop on Household Air Pollution and Monitoring

In March, Lisa Thompson RN, FNP, PhD, UCSF Associate Professor in the School of Nursing and Director of the PhD program in Global Health Sciences, was invited by the World Health Organization (WHO) to help lead a workshop with Dr. Kirk Smith’s research group from UC Berkeley. Twenty-one health professionals, researchers, and policy makers from Bhutan attended. The main purpose of the training was to equip participants with the necessary skills to design, implement, and monitor programs to reduce household air pollution, with a focus on how to evaluate interventions to address household air pollution-related health impacts. The workshop included formal teaching, hands-on demonstrations, fieldwork, and group work.

According to Dr. Thompson, due to Bhutan’s abundant supply of hydroelectric power, there is an opportunity to transition from polluting wood stoves to small, affordable electric induction cookers that heat quickly and efficiently. A key solution presented was the transition to less polluting induction cookers, which would reduce pollution-related health impacts.

The training helped participants learn how to evaluate household energy projects, including household and personal exposure monitoring, stove usage, and health impact assessments. Participants in the training developed their own proposals for future work including real-time assessment of household air pollution in Bhutanese households using improved cook stoves and transitional stoves and their associated health outcomes and a hospital-based study to assess the impact of household air pollution on low birth weight and preterm births. The next step is to find funding to support the proposals developed in the training. You can read more about the workshop summary and recommendations here.

Finding Balance

According to the Wall Street Journal the happiness index is “about finding balance—between modernity and tradition, between prosperity and ecological conservation, between material advancement and its discontents.” The advancement to electric cooking technology, coupled with hydroelectric power generation, is aligned with the goal to find a sustainable balance and will deliver both ecological and health benefits. It also will support Bhutan’s goal to eventually become zero emissions by 2030. The long-term challenge will be to create the infrastructure to support the new technology, while maintaining the well being Bhutan is known for.